Continuously Learn What Works

Health care contains problems needing fixed. How can we continually learn from experience, accumulate that experience to inform future choice-making and action?

Proem

When first diagnosed with Multiple Sclerosis, my neurologist told me he was expert in treating groups of people (populations) with MS, but he didn’t know crap about me. His job was to learn about me, and my job was to learn about MS. I shared what was important to me in my life, and he taught me about MS and treatments. We slowly learned what worked for me in care and treatment and what didn’t and re-examine year after year.

In last week’s podcast episode, we chatted with Duane Reynolds from the Just Health Collaborative. He guides health systems in creating cultures of belonging, enabling a fair and just opportunity for everyone to achieve optimal health. I wonder what worked and what didn’t among the interventions his clients tried?

When I worked at Boston Children’s Hospital, I was fascinated by their Cardiology Department’s Standardized Clinical Assessment And Management Plans (SCAMPs) to promote, not require, care standardization. SCAMPs “offered a clinician-designed approach to promoting care standardization that accommodates patients’ individual differences, respects providers’ clinical acumen, and keeps pace with the rapid growth of medical knowledge.” In lay terms, that was similar to my neurologist. People are different. Understand them, their preferences, stay up to date with research, make a treatment/care choice, and document what worked and what didn’t. Re-examine. Continually learn.

These three stories, my doctor and me, equity in health systems, care of children with severe heart problems, all contain a problem desperately needing fixing, choices — some based as research, others not — some action taken or no action. How can we continually learn from experience, share that cumulative experience to inform future choice-making and action?

Underwhelming response to brilliance

I have introduced this idea of continuously studying the impact of choices made by systems, clinicians, and individuals in many flavors and contexts for more than 20 years. Continuously studying the impact of choices made seems like such a…